Journal Article

8232 ‘Neonatal emergency team to labour ward!’ implementation of a neonatal multidisciplinary team (MDT) simulation programme to enable MDT confidence

Fenton-Jones, Mary, Mosuro, Anjola, Mincher, Holly, Followell, Sara

2025

Overview

Why did you do this work?A need for simulation training in our level 2 local neonatal unit (LNU) was identified following review of recent emergency cases. A neonatal multidisciplinary team (MDT) simulation programme was subsequently developed. The simulations aimed to enhance MDT confidence managing common neonatal emergencies, therefore improving patient safety. Simulation increases neonatal MDT competence and confidence and should be routinely undertaken.1 Emerging evidence shows simulation improves patient safety and team performance, with resultant improved patient outcomes in neonatal care.2 Additionally, with appropriate planning, team-based simulation training is feasible in busy neonatal units.3What did you do?Four neonatal MDT simulations ran on the LNU, labour or postnatal ward between September 2023 and March 2024. Multiple neonatal MDT practitioners participated (figure 1). Simulations were created with input from the STAR App4 and MPROvE Academy.5 The simulations included prematurity, meconium/hypoxic ischaemic injury, postnatal collapse (neonatal seizure) and difficult airway management. A post-simulation questionnaire was created for each, using paper and electronic forms. These contained short answer questions and a 5-point-Likert scale for rating confidence (0 no confidence to 4 very confident) before and after the simulation. Anonymised results were analysed.Abstract 8232 Figure 1What did you find?17 practitioners completed the post-simulation questionnaires from across the neonatal MDT. Relevant team leads supported practitioner attendance. Following the neonatal MDT simulations, all practitioners rated their confidence on the 5-point-Likert scale more highly than before, with mean self-reported confidence increasing after simulation participation (figure 2). In the prematurity simulation, mean confidence increased from 2.7 to a post-simulation confidence of 3.7. In the meconium/hypoxic ischaemic injury simulation, mean confidence increased from 2.3 to 3.3. The management of postnatal collapse (neonatal seizure) simulation saw mean confidence increase from 1.3 to 2.5; as did the difficult airway simulation, with mean increase from 1.8 to 2.4.Qualitative feedback suggested simulations used appropriate teams with varying experience. Participants expressed gaining confidence and knowledge; ‘helped build confidence in my decision making’ and ‘very interesting learning...’ Additionally, effective teamwork was highlighted, such as ‘problem solving as a team.’ One participant suggested simulations could be more challenging by starting in theatre.Abstract 8232 Figure 2What does it mean?Implementation of the neonatal MDT simulation programme showed the simulations increased practitioner confidence in neonatal emergency management. Qualitative analysis showed the simulations created a more confident and effective MDT, ultimately improving patient safety. The programme demonstrates feasibility of implementing simulation programmes in busy LNUs. Future intentions include expanding the MDT to involve midwifery colleagues and setting simulations in theatre. Furthermore, the programme is now established in departmental teaching and will be repeated as new practitioners rotate through the LNU. These plans aim to further enable a confident neonatal MDT, subsequently enhancing patient care.ReferencesFelton A, Cheshire K. Using Simulation-Based Training to Improve Neonatal Resuscitation Clinical Competency, Confidence, and Comfort Level of NICU Caregivers. The Journal of Continuing Education in Nursing 2024 Apr.Yousef N, Moreau R, Soghier L. Simulation in neonatal care: towards a change in traditional training? European Journal of Pediatrics. 2022 Apr.Reed DJW, Hermelin RL, Kennedy CS, Sharma J. Interdisciplinary onsite team-based simulation training in the neonatal intensive care unit: a pilot report. Journal of Perinatology. 2017 Apr.STAR. Simulation Tools and Resources (version 3.0). [Mobile application]. [Last accessed: June 2024].MPROvE MultiPROfessional neonatal Education. Available at: https://www.mproveacademy.com/. [Last accessed: June 2024].

• Publisher: BMJ Publishing Group LTD
• Subject: Confidence / Decision making / Emergency preparedness / Feces / Hypoxia / Ischemia / Likert scale / Likert Scales / Meconium / Multidisciplinary teams / Neonatal care / Neonates / Patient safety / Patients / Pediatrics / Periodicals / Postpartum period / Problem solving / Program Implementation / Qualitative analysis / Questionnaires / Respiratory tract / Safety / Seizures / Simulation / Training